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Ear anatomy
Ear anatomy


Definition:

Hearing loss is the total or partial inability to hear sound in one or both ears.

See also: Hearing loss of aging   



Alternative Names:

Decreased hearing; Deafness; Loss of hearing; Conductive hearing loss; Sensorineural hearing loss



Considerations:

Minor decreases in hearing are common after age 20.

Hearing problems usually come on gradually, and rarely end in complete deafness.

There are many causes of hearing loss. Hearing loss can be divided into two main categories:

  • Conductive hearing loss (CHL) occurs because of a mechanical problem in the outer or middle ear. The three tiny bones of the ear (ossicles) may not conduct sound properly, or the eardrum may not vibrate in response to sound. Fluid in the middle ear can cause this type of hearing loss.
  • Sensorineural hearing loss (SNHL) results when there is a problem with the inner ear. It most often occurs when the tiny hair cells (nerve endings) that transmit sound through the ear are injured, diseased, do not function properly, or have prematurely died. This type of hearing loss is sometimes called "nerve damage," although this is not accurate.

CHL is often reversible. SNHL is not. People who have both forms of hearing loss are said to have mixed hearing loss.

HEARING LOSS IN CHILDREN

Screening for hearing loss is now recommended for all newborns. In children, hearing problems may cause speech to develop slowly.

Ear infections are the most common cause of temporary hearing loss in children. Fluid may stay in the ear following an ear infection. The fluid can go unnoticed, or it can cause significant hearing problems in children. Any fluid that remains longer than 8 - 12 weeks is cause for concern.

Preventing hearing loss is more effective than treating it after the damage is done.



Common Causes:

Genetic:

Congenital:

Infectious:

Traumatic:

  • Acoustic trauma such as from explosions, fireworks, gunfire, rock concerts, and earphones
  • Barotrauma (differences in pressure)
  • Skull fracture (temporal bone)
  • Traumatic perforation of the eardrum

Toxic:

  • Aminoglycoside antibiotics
  • Aspirin
  • Chloroquine
  • Ethacrynic acid - oral
  • Quinidine

Age-related:

Occupational:

  • Working around loud noises on a continuous day-to-day basis can damage nerve cells responsible for hearing; Increased attention to conditions in the work environment has greatly decreased the chances of work-related hearing loss. See: Occupational hearing loss

Other:

Temporary hearing loss can be caused by:



Home Care:

Wax build-up can frequently be flushed out of the ear (gently) with ear syringes (available in drug stores) and warm water. Wax softeners (like Cerumenex) may be needed if the wax is hard and impacted.

Care should be taken when removing foreign bodies. Unless it is easy to get to, have your health care provider remove the object. Don't use sharp instruments to remove foreign bodies.



Call your health care provider if:

Call your health care provider if:

  • Hearing problems interfere with your lifestyle
  • Hearing problems are persistent and unexplained
  • There is sudden, severe hearing loss or ringing in the ears (tinnitus)
  • You have other symptoms, such as ear pain , along with hearing problems


What to expect at your health care provider's office:

The health care provider will take your medical history and do a physical examination.

Medical history questions documenting hearing loss in detail may include:

  • Is the hearing loss in both ears or one ear?
  • Is the hearing loss mild or severe?
  • Is all of the hearing lost (inability to hear any sound)?
  • Is there decreased hearing acuity (do words sound garbled)?
  • Is there decreased ability to understand speech?
  • Is there decreased ability to locate the source of a sound?
  • How long has the hearing loss been present?
  • Did it occur before age 30?
  • What other symptoms are also present?
  • Is there tinnitus (ringing or other sounds)?
  • Is there ear pain?
  • Is there dizziness or vertigo?

The physical examination will include a detailed examination of the ears.

Diagnostic tests that may be performed include:

A hearing aid or cochlear implant may be provided to improve hearing.



References:

Baloh RW. Hearing and Equilibrium. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, PA : Saunders Elsevier; 2007: chap 454.

Wrightson AS. Universal newborn hearing screening. Am Fam Physician. 2007; 75(9):1349.




Review Date: 4/13/2009
Reviewed By: Alan Lipkin, MD, Otolaryngologist, Private Practice, Denver, Colorado. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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